Remittance Form - Academic

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ACADEMIC TUTORING HILLFIELD STRATHALLAN COLLEGE

RECORD OF ON CAMPUS SERVICES MONTH: ____________________________________________________________ TUTOR NAME: ________________________________________________ TOTAL # OF SESSONS DURING PERIOD: _____________________________ TOTAL SESSON FEES FOR PERIOD: $_________________________________ 10% FEE DUE FOR PERIOD: $_________________________________________ + LUNCHES: # DAYS @ $5.65 ($5 plus HST): $________________________ Total Payment Submitted: $__________________________________________

BFO USE ONLY PAYMENT DATE: ______________ RECEIVED BY: _________________ Cheque #: _____________________ Deposit fees to 01-4234-110 $ _________________________ Deposit lunches to 01-6515-137 $ _____________________ Deposit HST to 01-2031-000 $ _________________________

Submission Statement I confirm that the above information is a true, accurate, and complete account of the total number of sessons provided and related fees billed at Hillfield Strathallan College during the specified period and is in compliance with the Academic Tutor Agreement between myself and Hillfield Strathallan College. ___________________________________________________ Signature


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